Internal medicine journal
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Internal medicine journal · Oct 2016
The epidemiology of in-hospital cardiac arrests in Australia and New Zealand.
The epidemiology of in-hospital cardiac arrests (IHCA) in Australia and New Zealand (ANZ) has not been systematically assessed. ⋯ IHCA are uncommon in ANZ and three quarters die in-hospital. However, their frequency varies markedly across institutions and may be affected by the presence of RRS. Where reported, the long-term outcomes survivors appear to have acceptable neurological outcomes.
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We report two cases of fulminant type 1 diabetes in previously well migrants from South East Asia. This entity, which is rare outside East or South-East Asia, has a high perinatal mortality. The clinical presentation differs markedly from that of typical newly recognised type 1 diabetes in pregnancy. In both our cases, the neonates required intensive care but survived.
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Internal medicine journal · Oct 2016
Letter Case ReportsA rare case of coeliac disease in an African teenager.
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Internal medicine journal · Sep 2016
ReviewThe ABCs of entrustable professional activities: an overview of 'entrustable professional activities' in medical education.
Consultants regularly need to decide whether a trainee can be entrusted to perform a clinical activity independently. 'Entrustable professional activities' (EPA) provide a framework for justifying and better utilising supervisor entrustment decisions for trainee feedback and assessment in the workplace. Since being proposed by Olle ten Cate in 2005, EPA are emerging as an integral part of many international medical curricula, and are being considered by the Royal Australasian College of Physicians in the current review of physician training. EPA are defined as tasks or responsibilities that can be entrusted to a trainee once sufficient competence is reached to allow for unsupervised practice. ⋯ EPA-based assessment is gaining momentum, amongst significant concerns regarding feasibility of implementation. While the optimal process for designing and implementing EPA remains to be determined, it is an assessment strategy where the over-arching goal of optimal patient care remains in clear sight. This review explores the central role of trust in medical training, the case for EPA and potential barriers to implementing EPA-based assessment.
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A core consideration in the care of Indigenous patients at the end of life is their place of death. Dying in community can be of paramount importance to Indigenous people. This paper reports the experiences of the Top End Palliative Care Service with respect to the barriers and solutions in the return of Indigenous patients to community for end-of-life care. These barriers include not only those associated with the significant distances and remoteness in the Northern Territory but, also, spiritual and cultural factors, which often influence healthcare delivery.